Cooperative
Extension
Service


University of Illinois
at
Urbana-Champaign


No. 25/December 5, 1997

1998 Illinois Agricultural Pesticides Conference

Preregistration Form
1998 Illinois Agricultural Pesticides Conference
UFAS 1-3-63895-0660

Conference dates: January 6, 7, and 8, 1998
Location: University of Illinois llini Union, Urbana, Illinois

Please mail completed preregistration form(s) or fax to (217)333-9561 by December 19, 1997.

Name

Company/business

Address

City/state/zip

Telephone (business)
(home)

Method of payment:
_____ Check enclosed (make payable to the University of Illinois)
_____ I prefer to charge on credit card: Visa _____ MasterCard _____
Card no. ________________ Expiration date _____

Signature of card holder ______________________

Preregistration: $75 per person (includes one copy each of the 1998 Conference Proceedings and the 1998 Illinois Agricultural Pest Management Handbook). Walk-in registration fee is $90.

Banquet: $40 per person, not included in the cost of registration.NOTE: If paying for more than one person, please enclose a completed preregistration form for each person (one check may be written to cover total payment).
Mail completed preregistration form(s) along with payment to

University of Illinois at Urbana-Champaign
Accounting Business Office
Administration Building Room 162
506 South Wright Street
Urbana, IL 61801